Systems and methods for determining and visualizing a functional relationship between a vascular network and perfused tissue

ABSTRACT

Systems and methods are disclosed for creating an interactive tool for determining and displaying a functional relationship between a vascular network and an associated perfused tissue. One method includes receiving a patient-specific vascular model of a patient&#39;s anatomy, including at least one vessel of the patient; receiving a patient-specific tissue model, including a tissue region associated with the at least one vessel of the patient; receiving a selected area of the vascular model or a selected area of the tissue model; and generating a display of a region of the tissue model corresponding to the selected area of the vascular model or a display of a portion of the vascular model corresponding to the selected area of the tissue model, respectively.

RELATED APPLICATION(S)

This application claims priority to U.S. Provisional Application No.62/141,895 filed Apr. 2, 2015, the entire disclosure of which is herebyincorporated herein by reference in its entirety.

FIELD OF THE DISCLOSURE

Various embodiments of the present disclosure relate generally tofunctional assessments of a patient's body, visualizations, and relatedmethods. More specifically, particular embodiments of the presentdisclosure relate to systems and methods for creating an interactivetool for determining and displaying a functional relationship between avascular network and an associated perfused tissue.

BACKGROUND

Many forms of disease treatment and assessment exist, includingevaluations of various risks to a patient, cost, and treatment efficacy.For example, several solutions exist to prevent and treat coronary heartdisease, a leading cause of death worldwide. Assessments of diseaseseverity and/or cause can improve treatment. Disease or disease severitymay be linked to issues with blood supply. Insights into vasculaturesupplying tissue regions may help triage or quickly target an area forfurther assessment and/or treatment. Thus, a desire exists forassessments that can show functional relationship(s) between a vascularnetwork and a perfused organ.

The foregoing general description and the following detailed descriptionare exemplary and explanatory only and are not restrictive of thedisclosure.

SUMMARY

According to certain aspects of the present disclosure, systems andmethods are disclosed for creating an interactive tool for determiningand displaying a functional relationship between a vascular network andan associated perfused tissue.

One method includes: receiving a patient-specific vascular model of apatient's anatomy, including at least one vessel of the patient;receiving a patient-specific tissue model, including a tissue regionassociated with the at least one vessel of the patient; receiving aselected area of the vascular model or a selected area of the tissuemodel; and generating a display of a region of the tissue modelcorresponding to the selected area of the vascular model or a display ofa portion of the vascular model corresponding to the selected area ofthe tissue model, respectively.

In accordance with another embodiment, a system for creating aninteractive tool for determining and displaying a functionalrelationship between a vascular network and an associated perfusedtissue: a data storage device storing instructions for creating aninteractive tool for determining and displaying a functionalrelationship between a vascular network and an associated perfusedtissue; and a processor configured for: receiving a patient-specificvascular model of a patient's anatomy, including at least one vessel ofthe patient; receiving a patient-specific tissue model, including atissue region associated with the at least one vessel of the patient;receiving a selected area of the vascular model or a selected area ofthe tissue model; and generating a display of a region of the tissuemodel corresponding to the selected area of the vascular model or adisplay of a portion of the vascular model corresponding to the selectedarea of the tissue model, respectively.

In accordance with another embodiment, a non-transitory computerreadable medium for use on a computer system containingcomputer-executable programming instructions for performing a method ofcreating an interactive tool for determining and displaying a functionalrelationship between a vascular network and an associated perfusedtissue, the method comprising: receiving a patient-specific vascularmodel of a patient's anatomy, including at least one vessel of thepatient; receiving a patient-specific tissue model, including a tissueregion associated with the at least one vessel of the patient; receivinga selected area of the vascular model or a selected area of the tissuemodel; and generating a display of a region of the tissue modelcorresponding to the selected area of the vascular model or a display ofa portion of the vascular model corresponding to the selected area ofthe tissue model, respectively.

Additional objects and advantages of the disclosed embodiments will beset forth in part in the description that follows, and in part will beapparent from the description, or may be learned by practice of thedisclosed embodiments. The objects and advantages of the disclosedembodiments will be realized and attained by means of the elements andcombinations particularly pointed out in the appended claims.

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and explanatory onlyand are not restrictive of the disclosed embodiments, as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate various exemplary embodiments,and together with the description, serve to explain the principles ofthe disclosed embodiments.

FIG. 1 is a block diagram of an exemplary system and network forcreating an interactive tool for determining and displaying a functionalrelationship between a vascular network and an associated perfusedtissue, according to an exemplary embodiment of the present disclosure.

FIG. 2A is a flowchart of an exemplary method of creating an interactivetool for determining and displaying a functional relationship between avascular network and an associated perfused tissue, according to anexemplary embodiment of the present disclosure.

FIG. 2B is a flowchart of an exemplary method of creating an interactivetool for determining and displaying a functional relationship between acoronary vascular network and a myocardium, according to an exemplaryembodiment of the present disclosure.

FIG. 3A is a flowchart of another exemplary method of creating aninteractive tool for determining and displaying a functionalrelationship between a vascular network and an associated perfusedtissue, according to an exemplary embodiment of the present disclosure.

FIG. 3B is a flowchart of another exemplary method of creating aninteractive tool for determining and displaying a functionalrelationship between a coronary vascular network and a myocardium,according to an exemplary embodiment of the present disclosure.

FIG. 4A is a flowchart of an exemplary method of creating an interactivetool for determining and displaying functional information associatedwith a vascular network and an associated perfused tissue, according toan exemplary embodiment of the present disclosure.

FIG. 4B is a flowchart of an exemplary method of creating an interactivetool for determining and displaying a functional information associatedwith a coronary vascular network and a myocardium, according to anexemplary embodiment of the present disclosure.

FIGS. 5A and 5B include diagrams of user interfaces configured fordisplaying a functional relationship(s) between a vascular network andassociated perfused tissue, according to exemplary embodiments of thepresent disclosure.

DESCRIPTION OF THE EMBODIMENTS

Reference will now be made in detail to the exemplary embodiments of thedisclosure, examples of which are illustrated in the accompanyingdrawings. Wherever possible, the same reference numbers will be usedthroughout the drawings to refer to the same or like parts.

Disease may be linked to issues with blood supply. Thus, a desire existsfor assessments that can show functional relationship(s) between avascular network and a perfused organ. The present disclosure includessystems and methods for visualizing the functional relationship betweena vascular network and a corresponding perfused organ. For example, thepresent disclosure describes a patient-specific interactive tool to helpa user visualize such a functional relationship. The tool may enable auser to visualize blood supply cause-and-effect at a global and/orregional scale, under various treatment and/or physiological conditions.For example, in a scenario involving a coronary vascular network andmyocardium associated with the coronary network, a user may select(e.g., click on) a coronary vessel displayed in the tool, and the toolmay determine (including displaying by lighting up or coloring) acorresponding portion of myocardial tissue with blood supplied by thecoronary vessel selected by the user. In another instance, the user ofthe previous example may select a portion of myocardial tissue, and thetool may determine and highlight a portion of the coronary vascularnetwork supplying blood to the selected tissue. The display may furtherinclude fluid modeling or indicators for tissue characteristics andconsequent perfusion/blood flow (e.g., from scar tissue or as an effectof one or more treatments).

Displays may further include suggested vessels or tissue portions toselect for displaying functional relationships, e.g., based on receivedpatient images or data associated with a plurality of individuals. Forexample, patient images may show some issues or irregularities (e.g.,scar tissue, stenosis, plaque, etc.). Such issues or irregularities maybe detected from imaging, based on contrast intensity or gradients, forinstance. Data associated with previous patients or a plurality ofindividuals may also indicate some portions of vasculature that may becrucial or prone to issues (e.g., embolism). In such cases, displays mayinclude recommendations as to vasculature or tissue for a user toselect, in order to pinpoint or troubleshoot possible circulatory issuesfor a particular patient. In some scenarios, the displays may bepresented as a workflow of a series of user interfaces, where mostsevere or significant trouble areas of vasculature or tissue arerecommended for selection first, and less crucial areas of vasculatureor tissue are recommended in subsequent user interfaces. Displays mayinclude three-dimensional (3D) or two-dimensional (2D) representationsof a patient's vasculature or tissue. Displays may further includehistograms or charts, e.g., charts comparing a percentage of tissueaffected for various selected vessels, charts comparing a percentage oftissue affected by the geometry of a single selected vessel over time orover various physiological states, charts comparing various treatmentsin terms of effects of each of the treatments on tissue or vasculature,etc.

The present disclosure may include systems and methods for planning andassessing the effectiveness of vascular related treatments for apatient, for example, by creating an interactive tool for determiningand displaying a functional relationship between a vascular network andan associated perfused tissue. In addition, the present disclosure mayinclude systems and methods for assisting in the treatment or relief ofone or more vascular conditions, e.g., by suggesting effectivetreatment(s). This disclosure may also assist in the design anddevelopment of surgery or new vascular devices. Further, the disclosuremay include embodiments that may be used as patient educational tool(s).

Referring now to the figures, FIG. 1 depicts a block diagram of anexemplary system 100 and network for creating an interactive tool fordetermining and displaying a functional relationship between a vascularnetwork and an associated perfused tissue, according to an exemplaryembodiment. Specifically, FIG. 1 depicts a plurality of physicians 102and third party providers 104, any of whom may be connected to anelectronic network 101, such as the Internet, through one or morecomputers, servers, and/or handheld mobile devices. Physicians 102and/or third party providers 104 may create or otherwise obtain imagesof one or more patients' anatomies. The physicians 102 and/or thirdparty providers 104 may also obtain any combination of patient-specificinformation, such as age, medical history, blood pressure, bloodviscosity, patient activity or exercise level, etc. Physicians 102and/or third party providers 104 may transmit the anatomical imagesand/or patient-specific information to server systems 106 over theelectronic network 101. Server systems 106 may include storage devicesfor storing images and data received from physicians 102 and/or thirdparty providers 104. Server systems 106 may also include processingdevices for processing images and data stored in the storage devices.For the purposes of the disclosure, “patient” may refer to anyindividual or person for whom diagnosis or treatment analysis is beingperformed, or any individual or person associated with the diagnosis ortreatment analysis of one or more individuals.

FIG. 2A depicts an exemplary embodiment of creating an interactive toolof a functional relationship between a vascular network and anassociated perfused tissue, where a user may select or indicate aportion of vasculature and the tool may determine and show a tissueregion perfused by the indicated vasculature. FIG. 3A depicts anexemplary embodiment of creating an interactive tool of a functionalrelationship between a vascular network and an associated perfusedtissue, where a user may select or indicate a tissue region and the toolmay determine and show a section of vasculature supplying blood to theindicated tissue region, or a section of vasculature from which theindicated tissue region may receive blood. FIGS. 2B and 3B are detailedembodiments of the methods of FIGS. 2A and 3A, respectively. Forexample, the method of FIG. 2B may apply the method of FIG. 2A to acoronary vasculature and myocardial tissue. Likewise, the method of FIG.3B may apply the method of FIG. 3A to a coronary vasculature andmyocardial tissue. FIG. 4A depicts an exemplary embodiment of a processfor estimating and displaying a blood distribution (e.g., a blood supplyestimate) from a vascular network to a target tissue. FIG. 4B depicts adetailed embodiment of the method of FIG. 4A, applying the method ofFIG. 4A to a coronary vasculature and myocardial tissue. FIGS. 5A and 5Binclude exemplary user interfaces produced by the embodiments describedin FIGS. 2A-4B.

FIG. 2A is a flowchart of an exemplary method 200 of creating aninteractive tool for determining and displaying a functionalrelationship between a vascular network and an associated perfusedtissue, according to an exemplary embodiment. The method of FIG. 2A maybe performed by server systems 106, based on information, images, anddata received from physicians 102 and/or third party providers 104 overelectronic network 101.

In one embodiment, step 201 may include receiving a patient-specificvascular model in an electronic storage medium of the server systems106. The electronic storage medium may include, for example, a harddrive, network drive, cloud drive, mobile phone, tablet, etc. In oneembodiment, the vascular model may be derived from images of the personacquired via one or more available imaging or scanning modalities (e.g.,computed tomography (CT) scans and/or magnetic resonance imaging (MRI)).For example, step 201 may include receiving CT and/or MRI images of aperson's vasculature. Step 201 may further include generating, from thereceived images, a patient-specific vascular model for the particularperson.

In one embodiment, step 203 may include receiving a patient-specifictissue model in an electronic storage medium of the server systems 106.The tissue of the patient-specific tissue model may include tissue inwhich blood supply may be estimated. At least a portion of the tissue ofthe patient-specific tissue model may include target tissue, where thetarget tissue may include tissue which is being evaluated by a user.

In one embodiment, step 205 may include receiving and/or determining anassociation between one or more locations on the vascular model (e.g.,of step 201) and one or more regions of the tissue model (e.g., thetarget tissue of the patient-specific tissue model of step 203), wherethe association may be based on regions of the tissue model thatcorrespond to the one or more locations of the vascular model by way ofperfusion territories of the one or more locations of the vascularmodel. For example, step 205 may include determining a location of thevascular model of step 201 and determining a perfusion territory of thevascular model within the patient-specific tissue model of step 203.Step 205 may include identifying the determined perfusion territory asbeing associated with the location of the vascular model. Similarly,step 205 may include determining a tissue region of the patient-specifictissue model of step 203 as being within the perfusion territory of aportion of the vascular model of step 201. Step 205 may includereceiving and/or determining correspondences between a patient-specificvascular model and a patient-specific tissue model.

In one embodiment, step 207 may include receiving a specified locationof the vascular model. The specified location may be received via a userinput, e.g., from a user selection of a variety of options. Userinteraction for selection may include a movement or gesture, movement ofa pointer (e.g., a computer mouse), and/or scrolling function across arendering of the patient-specific model.

In one embodiment, step 209 may include determining, using a processor,one or more regions of tissue supplied by blood passing through thereceived specified location (e.g., of step 207). For example, the one ormore regions of tissue may include at least a portion of target tissue.In one embodiment, step 209 may include determining, from the tissue ofthe patient-specific tissue model, the one or more regions of tissuesupplied by the location of the vascular model specified in step 207.The determination(s) made in step 209 may be based on the associationsbetween the vascular model and the tissue model of step 205.

In one embodiment, step 211 may include outputting the one or moreregions of the target tissue supplied by the blood passing through theindicated location. For example, the output of step 211 may include avisual display or an output to an electronic storage medium. In oneembodiment, step 211 may further include a visual display or an entryinto an electronic storage medium comprising a blood flow characteristicassociated with the blood passing through the indicated location. Afurther step may include determining such a blood flow characteristic,e.g., blood pressure, blood flow rate, blood flow volume, or a metriccomprised of a comparison of any of blood flow characteristics, etc. Thevisual display may include user-interactive features or any sensorsknown in the art for receiving user input known in the art.

In one embodiment, method 200 may further include treatment analysis.For example, output from step 211 may be used to compare severaltreatments, where visual displays may be generated for one or moretreatments (e.g., various types of medication, exercise regimens,treatment procedures, and/or implants). The effects of each of thetreatments can be compared, either simultaneously in one display, or ina series of displays. Furthermore, method 200 may include using thecomparison to select a treatment for a patient, either for the personfor which the patient-specific anatomic model was constructed (e.g., instep 201) or for another patient (e.g., a patient with characteristicsor circumstances similar to the person modeled in step 201).

FIG. 2B is a flowchart of an exemplary method 220 of creating aninteractive tool for a functional relationship between a coronaryvascular network and a myocardium, according to an exemplary embodiment.The method of FIG. 2B may be performed by server systems 106, based oninformation, images, and data received from physicians 102 and/or thirdparty providers 104 over electronic network 101.

In one embodiment, step 221 may include receiving a patient-specificcoronary model in an electronic storage medium of the server systems106. The electronic storage medium may include, for example, a harddrive, network drive, cloud drive, mobile phone, tablet, etc. In oneembodiment, the coronary model may be obtained via segmentation of animaging study, e.g., a coronary computed tomography angiography (cCTA)or magnetic resonance imaging (MRI).

In one embodiment, step 223 may include receiving a patient-specificmyocardial model in an electronic storage medium of the server systems106. The tissue of the patient-specific tissue model may include tissuein which blood supply may be estimated. At least a portion of the tissueof the patient-specific tissue model may include target tissue, wherethe target tissue may include tissue which is being evaluated by a user.This patient-specific myocardial model may be obtained via segmentationof an imaging study, e.g., cCTA or MRI.

In one embodiment, step 225 may include receiving and/or determining anassociation between one or more locations on the vascular model (e.g.,of step 221) and one or more regions of the tissue model (e.g., thetarget tissue of the patient-specific tissue model of step 223). Theassociation may be based on regions of the tissue model that correspondto the one or more locations of the vascular model by way of perfusionterritories of the one or more locations of the vascular model. Forexample, the association may include matching one or more outlets of thecoronary model to corresponding, respective regions of the myocardialmodel. For instance, step 225 may include matching an outlet of thecoronary model to a region of the myocardium, for one or more outlets ofthe coronary model.

In one embodiment, step 227 may include generating a display of thepatient-specific coronary model (e.g., a 3-dimensional display of thecoronary model). In one embodiment, step 227 may further includeprompting and/or receiving an indicated location of the coronary model(e.g., via user interaction with the 3-dimensional display of thecoronary model).

In one embodiment, step 229 may include determining, using a processor,one or more regions of tissue (e.g., myocardial tissue) supplied byblood passing through the received specified location (e.g., of step227). In one embodiment, step 229 may include identifying a sub-tree ofthe modeled coronary tree distal to the indicated location (of step 227)and summing together portions of the myocardium territory associatedwith the indicated location. For example, step 229 may be performedusing a union operation. In one such scenario, a union operation mayinclude identifying one or more sub-trees associated with outletsdownstream from the indicated location. The union operation may furtherinclude merging the identified sub-trees into a single tree. This treemay represent an overall myocardial sub-tree associated with theindicated location.

In one embodiment, step 231 may include outputting the one or moreregions of the target tissue supplied by the blood passing through theindicated location. For example, the output of step 231 may include avisual display or an output to an electronic storage medium. Forexample, step 231 may include displaying the one or more regions on a3-dimensional model of the myocardium (e.g., by coloring the region) orby coloring a representation of the myocardium (e.g., a 17-segment“bulls-eye” model).

FIG. 3A is a flowchart of an exemplary method 300 of an exemplary methodof creating an interactive tool for determining and displaying afunctional relationship between a vascular network and an associatedperfused tissue, according to an exemplary embodiment. The method ofFIG. 3A may be performed by server systems 106, based on information,images, and data received from physicians 102 and/or third partyproviders 104 over electronic network 101.

In one embodiment, step 301 may include receiving a patient-specificvascular model in an electronic storage medium of the server systems106. The electronic storage medium may include, for example, a harddrive, network drive, cloud drive, mobile phone, tablet, etc. In oneembodiment, the vascular model may be derived from images of the personacquired via one or more available imaging or scanning modalities (e.g.,computed tomography (CT) scans and/or magnetic resonance imaging (MRI)).For example, step 301 may include receiving CT and/or MRI images of aperson's vasculature. Step 301 may further include generating, from thereceived images, a patient-specific vascular model for the particularperson.

In one embodiment, step 303 may include receiving a patient-specifictissue model in an electronic storage medium of the server systems 106.The tissue of the patient-specific tissue model may include tissue inwhich blood supply may be estimated. At least a portion of the tissue ofthe patient-specific tissue model may include target tissue, where thetarget tissue may include tissue which is being evaluated by a user.

In one embodiment, step 305 may include receiving and/or determining anassociation between one or more locations on the vascular model (e.g.,of step 301) and one or more regions of the tissue model (e.g., thetarget tissue of the patient-specific tissue model of step 303), wherethe association may be based on regions of the tissue model thatcorrespond to the one or more locations of the vascular model by way ofperfusion territories of the one or more locations of the vascularmodel. For example, step 305 may include determining a location of thevascular model of step 301 and determining a perfusion territory of thevascular model within the patient-specific tissue model of step 303.Step 305 may include identifying the determined perfusion territory asbeing associated with the location of the vascular model. Similarly,step 305 may include determining a tissue region of the patient-specifictissue model of step 303 as being within the perfusion territory of aportion of the vascular model of step 301. Step 305 may includereceiving and/or determining correspondences between a patient-specificvascular model and a patient-specific tissue model.

In one embodiment, step 307 may include receiving a specified locationor region of the tissue model (e.g., a specified location or region ofthe target tissue). The specified location or region may be received viaa user input, e.g., from a user selection of a variety of options. Userinteraction for selection may include a movement or gesture, movement ofa pointer (e.g., a computer mouse), and/or scrolling function across arendering of the patient-specific model.

In one embodiment, step 309 may include determining, using a processor,one or more regions of the vascular model supplying blood to thereceived specified location or region of the tissue model (e.g., of step307). The determination(s) made in step 309 may be based on theassociations between the vascular model and the tissue model of step305.

In one embodiment, step 311 may include outputting the one or moreregions of the vascular model supplying blood to the received specifiedlocation or region (e.g., of step 307). For example, the output of step311 may include a visual display or an output to an electronic storagemedium. In one embodiment, step 311 may further include a visual displayor an entry into an electronic storage medium comprising a blood flowcharacteristic associated with the blood passing through the indicatedlocation or region of tissue. A further step may include determiningsuch a blood flow characteristic, e.g., blood pressure, blood flow rate,blood flow volume, or a metric comprised of a comparison of any of bloodflow characteristics, etc. The visual display may includeuser-interactive features or any sensors known in the art for receivinguser input known in the art.

In one embodiment, method 300 may further include treatment analysis.For example, output from step 311 may be used to compare severaltreatments, where visual displays may be generated for one or moretreatments (e.g., various types of medication, exercise regimens,treatment procedures, and/or implants). The effects of each of thetreatments can be compared, either simultaneously in one display, or ina series of displays. Furthermore, method 300 may include using thecomparison to select a treatment for a patient, either for the personfor which the patient-specific anatomic model was constructed (e.g., instep 301) or for another patient (e.g., a patient with characteristicsor circumstances similar to the person modeled in step 301).

FIG. 3B is a flowchart of an exemplary method 320 of creating aninteractive tool for a functional relationship between a coronaryvascular network and a myocardium, according to an exemplary embodiment.The method of FIG. 3B may be performed by server systems 106, based oninformation, images, and data received from physicians 102 and/or thirdparty providers 104 over electronic network 101.

In one embodiment, step 321 may include receiving a patient-specificcoronary model as a patient-specific vascular model in an electronicstorage medium of the server systems 106. The electronic storage mediummay include, for example, a hard drive, network drive, cloud drive,mobile phone, tablet, etc. In one embodiment, the coronary model may beobtained via segmentation of an imaging study, e.g., a coronary computedtomography angiography (cCTA) or magnetic resonance imaging (MRI).

In one embodiment, step 323 may include receiving a patient-specificmyocardial model as a patient-specific tissue model in an electronicstorage medium of the server systems 106. The tissue of thepatient-specific myocardial model may include tissue in which bloodsupply may be estimated. At least a portion of the tissue of thepatient-specific myocardial model may include target tissue, where thetarget tissue may include tissue which is being evaluated by a user.This patient-specific myocardial model may be obtained via segmentationof an imaging study, e.g., cCTA or MRI.

In one embodiment, step 325 may include receiving and/or determining anassociation between one or more locations on the patient-specificcoronary vascular model (e.g., of step 321) and one or more regions ofthe patient-specific myocardial model (e.g., the target tissue of thepatient-specific tissue model of step 323). The association may be basedon regions of the myocardial model that correspond to the one or morelocations of the coronary model by way of perfusion territories of theone or more locations of the vascular model. For example, theassociation may include matching one or more outlets of the coronarymodel to corresponding, respective regions of the myocardial model. Forinstance, step 325 may include matching an outlet of the coronary modelto a region of the myocardium, for one or more outlets of the coronarymodel.

In one embodiment, step 327 may include generating a display of thepatient-specific myocardial model (e.g., a 3-dimensional display of themyocardial model). Alternately or in addition, step 327 may includegenerating a display including a representation of the patient'smyocardium as “bulls-eye” plot (e.g., a 17-segment “bulls-eye” plot). Inone embodiment, step 327 may further include prompting and/or receivingan indicated location or region of the myocardial model (e.g., via userinteraction with the 3-dimensional display of the coronary model, with a“bulls-eye plot,” etc.).

In one embodiment, step 329 may include determining, using a processor,one or more regions of the coronary model supplying blood to thereceived specified location or region of the myocardial model (e.g., ofstep 327). In one embodiment, step 329 may include identifying asub-tree of the modeled coronary tree defined by tracing the indicatedlocation or region through associated outlets of the patient's modeledaortic ostium. This tracing may be performed by following the vesselcenterline downstream toward the vessel outlets. Following the directiontoward the vessel outlets of the coronary model may be determined inmultiple ways, for example, by moving along the coronary model in thedirection opposite the aorta connection, by moving in the direction ofanatomically smaller vessels of the coronary model, by moving in thedirection opposite of a bifurcation of the coronary model that containsa larger vessel, or by moving in the direction of computed (or measured)blood flow of the coronary model (e.g., by following a pressure gradientdownward or a flow direction).

In one embodiment, step 331 may include outputting the one or moreregions of the coronary model (e.g., the portion of the coronary tree ofthe coronary model) supplying blood to the indicated location or region.For example, the output of step 331 may include a visual display (e.g.,a 3-dimensional representation of the coronary model) or an output to anelectronic storage medium.

FIGS. 4A and 4B depict exemplary methods for displaying functionalinformation including blood supply/blood distribution either from aselected vascular network to a tissue region, or received by a selectedtissue region from an associated vascular network providing blood tothat selected tissue region. FIG. 4A depicts an exemplary embodiment ofa process for estimating and displaying a blood distribution (e.g., ablood supply estimate) from a vascular network to a target tissue. FIG.4B depicts a detailed embodiment of the method of FIG. 4A, applying themethod of FIG. 4A to a coronary vasculature and myocardial tissue.

FIG. 4A is a flowchart of an exemplary method 400 of an exemplary methodof creating an interactive tool for determining and displaying afunctional relationship between a vascular network and an associatedperfused tissue, according to an exemplary embodiment. The method ofFIG. 4A may be performed by server systems 106, based on information,images, and data received from physicians 102 and/or third partyproviders 104 over electronic network 101.

In one embodiment, step 401 may include receiving a patient-specificvascular model in an electronic storage medium of the server systems106. The electronic storage medium may include, for example, a harddrive, network drive, cloud drive, mobile phone, tablet, etc. In oneembodiment, the vascular model may be derived from images of the personacquired via one or more available imaging or scanning modalities (e.g.,computed tomography (CT) scans and/or magnetic resonance imaging (MRI)).For example, step 401 may include receiving CT and/or MRI images of aperson's vasculature. Step 401 may further include generating, from thereceived images, a patient-specific vascular model for the particularperson.

In one embodiment, step 403 may include receiving a patient-specifictissue model in an electronic storage medium of the server systems 106.The tissue of the patient-specific tissue model may include tissue inwhich blood supply may be estimated. At least a portion of the tissue ofthe patient-specific tissue model may include target tissue, where thetarget tissue may include tissue which is being evaluated by a user.

In one embodiment, step 405 may include receiving and/or determining aphysiological state of the patient and boundary conditions for thepatient-specific vascular model and/or the patient-specific tissuemodel.

In one embodiment, step 407 may include determining, using a processor,an estimate of a blood distribution in the vascular network (of at leasta portion of the patient-specific vascular model) and the target tissue(of at least a portion of the patient-specific tissue model). Exemplaryprocessors may include: a laptop, desktop, cloud computing architecture,GPU, DSP, mobile phone, tablet, etc. In one embodiment, the blooddistribution may be based on the received models and the receivedphysiological state, including the boundary conditions (e.g., of step405). The blood distribution may include a blood supply, e.g., anestimate expressed as blood pressure, blood flow, blood speed, bloodflow rate, etc. The blood distribution may be estimated usingcomputational fluid dynamics with the determined boundary conditions(e.g., a 3D model, reduced order model, 1D model, or 0D model).Alternatively or in addition, the blood distribution may be estimatedusing a statistical or machine learning technique from example data.

In one embodiment, step 409 may include outputting a representationand/or visual display of the patient-specific vascular model and/or thepatient-specific tissue model to an electronic storage medium or a userdisplay (e.g., a monitor, mobile phone, tablet, etc.). Therepresentation may comprise a model interface.

In one embodiment, step 411 may include projecting functionalinformation (e.g., the blood distribution estimate of step 407) onto theoutput of step 409. In one embodiment, the model interface may includefeatures for receiving and/or prompting user interaction. In oneembodiment, step 411 may include displaying a blood supply estimateinside or near a user selection of at least a portion of a vascularnetwork. Alternately or in addition, step 411 may include displaying ablood supply estimate inside or near a target tissue supplied by a userselected portion of a vascular network. In one embodiment, step 411 mayinclude displaying a blood supply estimate inside or near a userselection of at least a portion of a target tissue region. Alternatelyor in addition, step 411 may include displaying a blood supply estimateinside or near a vascular network responsible for supplying a userselected portion of target tissue.

User selection may include a movement or gesture, movement of a pointer(e.g., a computer mouse), and/or scrolling function across the modelinterface. In one embodiment, display(s) created in steps 409 and 411may include outlining and/or indicating user selections of thepatient-specific vascular model and/or the patient-specific tissuemodel. For example, a user may trace a target tissue on a screen showinga display of the patient-specific tissue model. Steps 409 and 411 mayinclude showing a colored line outlining the traced tissue region, withcorresponding functional information of the tissue shown alongside orwithin the colored line. Relationships between the projected functionalinformation and visual representations of the models may be conveyed viacolor coordination, overlays of functional information over selectedarea(s) of the model(s), proximity between displayed functionalinformation and selected area(s) of model(s), etc.

In one embodiment, step 413 may include determining and/or receiving amodification, e.g., a modification to the physiological state (e.g., ofstep 405). For example, step 413 may include prompting a user to modifya patient physiological state and/or determining a physiological statechange/new physiological state of the patient. Step 413 may furtherinclude determining and/or receiving boundary conditions associated withthe changed physiological state and updating renderings created in steps409 and 411. In other or additional embodiments, step 413 may includemodifications to the patient models, including modifications for changesover time (e.g., aging and/or plaque progression) and/or for simulationsof medical treatment (e.g., stent insertion or bypass procedures).

In one embodiment, steps 409 and 411 may be performed again, taking intoconsideration modification(s) received or determined in step 413. Forexample, functional information and/or model interface(s) may beregenerated and/or updated to incorporate the modifications. Forinstance, the geometry of a patient-specific vascular model may bemodified to model a stent insertion. Any change to boundary conditionsin light of the changed geometry may be applied to assessment offunctional information (e.g., blood flow rate through the modifiedgeometry of the patient-specific vascular model) and/or consequent bloodsupply to tissue associated with the modified portion of thepatient-specific vascular model. Such changes in model geometry andfunctional information may be displayed with steps 409 and 411. In someembodiments, steps 409 and 411 may further include simultaneous displaysof model interfaces. For example, repeating steps 409 and 411 mayproduce side-by-side comparisons and/or overlays of patient-specificmodels and/or functional information at various physiological states,geometric configurations, points in time, etc.

FIG. 4B is a flowchart of an exemplary method 420 of creating aninteractive tool for a functional relationship between a coronaryvascular network and a myocardium, according to an exemplary embodiment.The method of FIG. 4B may be performed by server systems 106, based oninformation, images, and data received from physicians 102 and/or thirdparty providers 104 over electronic network 101.

In one embodiment, step 421 may include receiving a patient-specificcardiovascular model in an electronic storage medium of the serversystems 106. The electronic storage medium may include, for example, ahard drive, network drive, cloud drive, mobile phone, tablet, etc. Thecardiovascular model may include large coronary vessels (e.g., obtainedvia imaging including CT or MR) and/or including microvascultureperfusing tissue. The microvasculature may be measured or simulated(e.g., via constrained constructive optimization or other similarmethods). The cardiovascular model may include arteries, veins, or acombination thereof. In one embodiment, the coronary model may beobtained via segmentation of an imaging study, e.g., a coronary computedtomography angiography (cCTA) or magnetic resonance imaging (MRI), orextracted from a medical imaging scan (e.g., CT or MR).

In one embodiment, step 423 may include receiving a patient-specificmyocardial model in an electronic storage medium of the server systems106. The tissue of the patient-specific tissue model may include tissuein which blood supply may be estimated. At least a portion of the tissueof the patient-specific tissue model may include target tissue, wherethe target tissue may include tissue which is being evaluated by a user.The myocardial model may include model(s) of the patient's epicardium,atrial wall, etc. This patient-specific myocardial model may be obtainedvia segmentation of an imaging study, e.g., cCTA or MRI, or extractedfrom a medical imaging scan (e.g., CT or MR).

In one embodiment, step 425 may include receiving and/or determining aphysiological state of the patient and/or cardiac phase of thecardiovascular model. The physiological state may include, for example,exercise state, resting state, hyperemic state, etc. Cardiac phases mayrefer to diastole, systole, etc. Step 425 may further include receivingand/or determining boundary conditions for the patient-specificcardiovascular model and/or the myocardial model, based on thereceived/determined physiological state or cardiac phase.

In one embodiment, step 427 may include determining, using a processor,an estimate of a blood supply in the patient's coronary vessels andmyocardium based on the patient-specific cardiovascular model (e.g., ofstep 421), the patient-specific myocardial model (e.g., of step 423),and the received/determined boundary conditions (e.g., of step 425).Exemplary processors may include: a laptop, desktop, cloud computingarchitecture, graphics processing unit (GPU), digital signal processor(DSP), mobile phone, tablet, etc. In one embodiment, estimating theblood supply may include determining blood flow in the cardiovascularmodel, e.g., using a patient-specific estimation of blood flow in thecoronary vessels. For example, step 427 may include estimating bloodflow demand (e.g., based on the myocardial mass of the myocardial model,of the patient, the total vascular volume of the patient's coronaryvessels, or the total vascular volume of the cardiovascular model).Estimating blood flow on the basis of blood flow demand may further beperformed using 3D computational fluid dynamics, a reduced order model,and/or using a database (e.g., via machine learning).

In one embodiment, estimating myocardium perfusion may include using apatient-specific estimation of blood advection-diffusion in themyocardium based on cardiovascular supply (e.g., blood supply to theheart, blood supply to the aorta, or some known blood pressure in thevessel tree). Estimating myocardium perfusion may also employ 3Dcomputational fluid dynamics, a reduced order model, and/or using adatabase (e.g., via machine learning).

In one embodiment, step 429 may include outputting a representationand/or visual display of the patient-specific vascular model and/or thepatient-specific tissue model to an electronic storage medium or a userdisplay (e.g., a monitor, mobile phone, tablet, etc.). Therepresentation may comprise a model interface. Model interfaces mayinclude 3D geometrical model(s) (e.g., a triangulated surface mesh) ofthe cardiovascular model and/or the myocardial model. Alternately or inaddition, the model interfaces may include 2D representation(s) of thecardiovascular model and/or the myocardial model, e.g., a projection ofthe cardiovascular model and/or a projection or “bull's-eye” plot of themyocardial model).

In one embodiment, step 431 may include projecting functionalinformation (e.g., the blood supply estimate of step 427) onto theoutput of step 429. In one embodiment, the model interface may includefeatures for receiving and/or prompting user interaction. In oneembodiment, step 431 may include displaying a blood supply estimateinside or near a user selection of at least a portion of the displayedcardiovascular network. Alternately or in addition, step 431 may includedisplaying a blood supply estimate inside or near a target myocardialtissue supplied by a user selected portion of a displayed cardiovascularnetwork. In one embodiment, step 431 may include displaying a bloodsupply estimate inside or near a user selection of at least a portion ofa target myocardial tissue region. Alternately or in addition, step 431may include displaying a blood supply estimate inside or near adisplayed cardiovascular network responsible for supplying a userselected portion of target myocardial tissue.

In one embodiment, step 433 may include determining and/or receiving amodification, e.g., a modification to the physiological state (e.g., ofstep 425). For example, step 413 may include prompting a user to modifya patient physiological state and/or determining a physiological statechange/new physiological state of the patient. Step 433 may furtherinclude determining and/or receiving boundary conditions associated withthe changed physiological state and updating renderings created in steps429 and 431. In other or additional embodiments, step 433 may includemodifications to the patient models, including modifications for changesover time (e.g., aging and/or plaque progression) and/or for simulationsof medical treatment (e.g., drugs, percutaneous coronary intervention(PCI), coronary artery bypass graft (CABG), myocardium ablation, etc.).

In one embodiment, steps 429 and 431 may be performed again, taking intoconsideration modification(s) received or determined in step 433. Forexample, functional information and/or model interface(s) may beregenerated and/or updated to incorporate the modifications. In someembodiments, steps 429 and 431 may further include simultaneous displaysof model interfaces as previously described for method 400 of FIG. 4A.

FIGS. 5A and 5B include diagrams of user interfaces displayingfunctional relationship(s) between a vascular network and associatedperfused tissue, according to an exemplary embodiment of the presentdisclosure.

In particular, FIG. 5A depicts a user interface 500 showing athree-dimensional coronary model 501 and a three-dimensional myocardialmodel 503, according to an exemplary embodiment of the presentdisclosure. The user interface 500 may include a vascular model prompt505 (e.g., prompting a user to select a location of the coronary model501). Alternately or in addition, the user interface 500 may include atissue model prompt 507 (e.g., prompting a user to select a region ofthe myocardial model 503). In one embodiment, the user interface 500 mayinclude a color change or other visual indication (e.g., shading,outlining, overlay, etc.) corresponding to a selected location orregion. In one embodiment, the user interface 500 may display a tissueregion 509 corresponding to a user response to the vascular model prompt505. Alternately or in addition, the user interface 500 may display atleast one vessel segment 511 corresponding to a user response to thetissue model prompt 507.

FIG. 5B depicts a user interface 520 showing a three-dimensionalcoronary model 521 and a two dimensional myocardial model (e.g., a“bull's-eye” plot 523), according to an exemplary embodiment of thepresent disclosure. The user interface 520 may include a vascular modelprompt 525 (e.g., prompting a user to select a location of the coronarymodel 521). Alternately or in addition, the user interface 520 mayinclude a tissue model prompt 527 (e.g., prompting a user to select aregion of the plot 523). In one embodiment, the user interface 520 mayinclude a color change or other visual indication (e.g., shading,outlining, overlay, etc.) corresponding to a selected location orregion. Alternately or in addition, the user interface 520 may displayat least one vessel segment 529 corresponding to a user response to thetissue model prompt 527. In one embodiment, the user interface 520 maydisplay a tissue region 531 corresponding to a user response to thevascular model prompt 525.

The present disclosure may also apply to carotid or cerebral vascularnetworks perfusion the brain, peripheral vasculature perusing muscle,renal vasculature supplying kidney(s), visceral vasculature supplyingbowels, a liver, or a spleen, etc.

Thus, the present disclosure advantageously describes systems andmethods for visualizing the functional relationship between a vascularnetwork and a corresponding perfused organ. For example, the systems andmethods describe a tool that displays a corresponding tissue region uponreceiving user selection of a vessel segment, and/or a correspondingvasculature upon receiving user selection of a tissue region. Suchdisplays show patient-specific blood supply cause-and-effect at a globaland/or regional scale, and under various treatment and/or physiologicalconditions. The display(s) further includes fluid modeling or indicatorsfor tissue characteristics and consequent perfusion/blood flow (e.g.,from scar tissue or as an effect of one or more treatments). Thedescribed systems and methods may improve treatment planning for therelief of one or more vascular conditions.

Other embodiments of the invention will be apparent to those skilled inthe art from consideration of the specification and practice of theinvention disclosed herein. It is intended that the specification andexamples be considered as exemplary only, with a true scope and spiritof the invention being indicated by the following claims.

What is claimed is:
 1. A computer-implemented method of creating aninteractive tool for determining and displaying a functionalrelationship between a vascular network and an associated perfusedtissue, the method comprising: receiving a patient-specific vascularmodel of a patient's anatomy; receiving a patient-specific tissue modelof the patient's anatomy, the patient-specific tissue model describing atissue supplied at least in part with blood through vasculaturedescribed by the patient-specific vascular model; generating a userinterface comprising a display of at least a portion of thepatient-specific vascular model and a display of at least a portion ofthe patient-specific tissue model; receiving, via the user interface, aselection of a first region, the first region being a region of one ofthe patient-specific vascular model and the patient-specific tissuemodel; and upon receiving the selection of the first region, determininga second region having a blood supply relationship with the firstregion, the second region being a region of another of thepatient-specific vascular model and the patient-specific tissue model,and displaying the second region in a manner indicating that the secondregion has the blood supply relationship with the first region.
 2. Thecomputer-implemented method of claim 1, wherein the first region is aregion of the patient-specific vascular model and represents a region ofthe vasculature, the second region is a region of the patient-specifictissue model, and the blood supply relationship is a relationship inwhich the second region represents a region, of the tissue, that issupplied by blood passing through the region of the vasculaturerepresented by the first region.
 3. The computer-implemented method ofclaim 1, wherein the display of the at least the portion of thepatient-specific tissue model includes a geometrical model of thepatient-specific tissue model, or a “bulls-eye” model of thepatient-specific tissue model.
 4. The computer-implemented method ofclaim 1, further comprising: receiving or determining an associationbetween a region of the patient-specific vascular model and a region ofthe patient-specific tissue model, wherein the association is based onthe region of the patient-specific tissue model being at least a portionof a perfusion territory of the location of the patient-specificvascular model.
 5. The computer-implemented method of claim 1, whereinthe patient-specific vascular model includes coronary, carotid,cerebral, peripheral, renal, and/or visceral vasculature.
 6. Thecomputer-implemented method of claim 1, wherein the patient-specifictissue model includes myocardial, brain, muscle, kidney, bowel, liver,and/or spleen tissue.
 7. The computer-implemented method of claim 1,wherein the method further comprises generating a user interfacecomprising a display of at least a portion of the patient-specificvascular model and a display of at least a portion of thepatient-specific tissue model, the user interface further displaying arecommendation of at least one region of the display of thepatient-specific vascular model within the generated user interface tobe selected by a user or of the display of the patient-specific tissuemodel within the generated user interface to be selected by a user, therecommendation indicates severe or significant trouble areas of thepatient-specific tissue model or the patient-specific vascular model,and the at least one region includes the first region.
 8. Thecomputer-implemented method of claim 1, wherein the first region is aregion of the patient-specific tissue model and represents a region ofthe tissue, the second region is a region of the patient-specificvascular model, and the blood supply relationship is a relationship inwhich the second region represents a region, of the vasculature, thatsupplies by blood to the region of the tissue represented by the firstregion.
 9. A system for creating an interactive tool for determining anddisplaying a functional relationship between a vascular network and anassociated perfused tissue, the system comprising: a data storage devicestoring instructions for creating an interactive tool for determiningand displaying a functional relationship between a vascular network andan associated perfused tissue; and a processor configured to execute theinstructions to perform a method including: receiving a patient-specificvascular model of a patient's anatomy; receiving a patient-specifictissue model of the patient's anatomy, the patient-specific tissue modeldescribing a tissue supplied at least in part with blood throughvasculature described by the patient-specific vascular model; generatinga user interface comprising a display of at least a portion of thepatient-specific vascular model and a display of at least a portion ofthe patient-specific tissue model; receiving, via the user interface, aselection of a first region, the first region being a region of one ofthe patient-specific vascular model and the patient-specific tissuemodel; and upon receiving the selection of the first region, determininga second region having a blood supply relationship with the firstregion, the second region being a region of another of thepatient-specific vascular model and the patient-specific tissue model,and displaying the second region in a manner indicating that the secondregion has the blood supply relationship with the first region.
 10. Thesystem of claim 9, wherein the first region is a region of thepatient-specific vascular model and represents a region of thevasculature, the second region is a region of the patient-specifictissue model, and the blood supply relationship is a relationship inwhich the second region represents a region, of the tissue, that issupplied by blood passing through the region of the vasculaturerepresented by the first region.
 11. The system of claim 9, wherein thedisplay of the at least the portion of the patient-specific tissue modelincludes a geometrical model of the patient-specific tissue model, or a“bulls-eye” model of the patient-specific tissue model.
 12. The systemof claim 9, wherein the system is further configured for: receiving ordetermining an association between a region of the patient-specificvascular model and a region of the patient-specific tissue model,wherein the association is based on the region of the patient-specifictissue model being at least a portion of a perfusion territory of thelocation of the patient-specific vascular model.
 13. The system of claim9, wherein the patient-specific vascular model includes coronary,carotid, cerebral, peripheral, renal, and/or visceral vasculature. 14.The system of claim 9, wherein the patient-specific tissue modelincludes myocardial, brain, muscle, kidney, bowel, liver, and/or spleentissue.
 15. The system of claim 9, the method further comprisesgenerating a user interface comprising a display of at least a portionof the patient-specific vascular model and a display of at least aportion of the patient-specific tissue model, the user interface furtherdisplaying a recommendation of at least one region of the display of thepatient-specific vascular model within the generated user interface tobe selected by a user or of the display of the patient-specific tissuemodel within the generated user interface to be selected by a user, therecommendation indicates severe or significant trouble areas of thepatient-specific tissue model or the patient-specific vascular model,and the at least one region includes the first region.
 16. The system ofclaim 9, wherein, wherein the first region is a region of thepatient-specific tissue model and represents a region of the tissue, thesecond region is a region of the patient-specific vascular model, andthe blood supply relationship is a relationship in which the secondregion represents a region, of the vasculature, that supplies by bloodto the region of the tissue represented by the first region.
 17. Anon-transitory computer readable medium for use on a computer systemcontaining computer-executable programming instructions for performing amethod of creating an interactive tool for determining and displaying afunctional relationship between a vascular network and an associatedperfused tissue, the method comprising: receiving a patient-specificvascular model of a patient's anatomy; receiving a patient-specifictissue model of the patient's anatomy, the patient-specific tissue modeldescribing a tissue supplied at least in part with blood throughvasculature described by the patient-specific vascular model; generatinga user interface comprising a display of at least a portion of thepatient-specific vascular model and a display of at least a portion ofthe patient-specific tissue model; receiving, via the user interface, aselection of a first region, the first region being a region of one ofthe patient-specific vascular model and the patient-specific tissuemodel; and upon receiving the selection of the first region, determininga second region having a blood supply relationship with the firstregion, the second region being a region of another of thepatient-specific vascular model and the patient-specific tissue model,and displaying the second region in a manner indicating that the secondregion has the blood supply relationship with the first region.
 18. Thenon-transitory computer readable medium of claim 17, wherein the firstregion is a region of the patient-specific vascular model and representsa region of the vasculature, the second region is a region of thepatient-specific tissue model, and the blood supply relationship is arelationship in which the second region represents a region, of thetissue, that is supplied by blood passing through the region of thevasculature represented by the first region.
 19. The non-transitorycomputer readable medium of claim 17, wherein the display of the atleast the portion of the patient-specific tissue model includes ageometrical model of the patient-specific tissue model, or a “bulls-eye”model of the patient-specific tissue model.
 20. The non-transitorycomputer readable medium of claim 17, wherein the first region is aregion of the patient-specific tissue model and represents a region ofthe tissue, the second region is a region of the patient-specificvascular model, and the blood supply relationship is a relationship inwhich the second region represents a region, of the vasculature, thatsupplies by blood to the region of the tissue represented by the firstregion.